Sriman Swarup is a board-certified hematologist-oncologist and the cofounder of OncoNexus, an AI-driven oncology workflow platform focused on improving efficiency and care delivery. He also leads Swarup Medical PLLC, where he consults on clinical systems design, health equity, and digital health transformation. Practicing in rural Arizona, Dr. Swarup manages more than 3,000 patient encounters each year while advising startups and health systems on innovation and health care strategy. He writes about medicine, technology, and health care leadership at his website.
As an oncologist, I’ve sat through the 24- to 48-hour EMR trainings that claim to prepare clinicians for new systems. They rarely do. The average physician still spends one to two days in technical onboarding and another month fumbling through screens before feeling comfortable. Versions vary wildly even within the same vendor, and every move to a new hospital resets the learning curve.
One night in a rural hospital, I watched …
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Why EMR usability is a patient safety issue
We tell ourselves documentation is for patient safety. For continuity. For protection. But let’s be honest. It’s for billing. And once you see that clearly, it is hard to unsee.
In training, I was taught that the note reflects the thinking of the physician. That it should tell the story of the patient and the rationale for each decision. But in practice, it does not. It is a tool for revenue …
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Why medical notes have become billing scripts instead of patient stories
